The artificial somato-autonomic reflex arch does not improve bowel function in subjects with spinal cord injury.

STUDY DESIGN: Prospective cohort study. OBJECTIVE: Although introduced for neurogenic bladder dysfunction, it has been suggested that the artificial somato-autonomic reflex arch alleviates neurogenic bowel dysfunction (NBD). We aimed at evaluating the effects of the reflex arch on NBD. SETTING: Denmark. METHODS: Ten subjects with supraconal spinal cord injury (SCI) (nine males, median age 46 years) had an anastomosis created between the ventral part of the fifth lumbar or first sacral nerve root and the ventral part of the second sacral nerve root. Standardized assessment of segmental colorectal transit times with radiopaque markers, evaluation of scintigraphic assessed colorectal emptying upon defecation, scintigraphic assessment of colorectal transport during stimulation of the reflex arch, standard anorectal physiology tests and colorectal symptoms were performed at baseline and 18 months after surgery. RESULTS: No significant change was observed in colorectal emptying upon defecation (median 31% of the rectosigmoid at baseline vs 75% at follow-up, P=0.50), no movement of colorectal contents was observed during stimulation of the reflex arch. Segmental colorectal transit times, anal sphincter pressures and rectal capacity did not change, and no change was seen in NBD score (median 13.5 (baseline) vs 12.5 (follow-up), P=0.51), St Marks fecal incontinence score (4.5 vs 5.0, P=0.36) and Cleveland constipation score (6.0 vs 8.0, P=0.75). CONCLUSIONS: The artificial somato-autonomic reflex arch has no effect on bowel function in subjects with supraconal SCI.

Combined DaT imaging and olfactory testing for differentiating parkinsonian disorders.

OBJECTIVE: Dopamine transporter (DaT) imaging with single photon emission computed tomography (SPECT) detects loss of striatal dopaminergic innervation with very high sensitivity. It cannot readily distinguish idiopathic Parkinson's disease (iPD) and dementia with Lewy bodies (DLB) from atypical disorders (aPD). However, most iPD/DLB patients are hyposmic, whereas the majority of aPD patients were reported to have intact olfaction. For this reason, we conducted a longitudinal follow-up study to investigate the power of combined DaT imaging and olfactory testing to predict the final diagnosis of the patients. MATERIALS AND METHODS: A total of 129 patients received [123I]FP-CIT SPECT and olfactory testing at baseline assessment. Clinical follow-up 30 ± 12 months later was the diagnostic standard of truth. A normative dataset of 24 healthy controls was used for comparison. RESULTS: Baseline DaT imaging predicted a dopamine-deficient diagnosis with 98% sensitivity and 98% specificity. The combined DaT/olfactory testing correctly classified 91% of patients as iPD/DLB (PPV 91%). The PPV rose to 97% or greater in anosmic patients. In contrast, only 45% of aPD patients were categorised correctly by combined DaT/olfactory testing - mainly because of the presence of normosmic iPD patients. CONCLUSIONS: In patients with an abnormal DaT SPECT, hyposmia yields an a posteriori likelihood of iPD/DLB of > 90%. In contrast, a finding of normosmia only increases the a posteriori likelihood of aPD to approximately the 50%.

Colorectal transport during defecation in subjects with supraconal spinal cord injury.

STUDY DESIGN: Clinical study. OBJECTIVES: To explore how supraconal spinal cord injury (SCI) affects colorectal emptying at defecation. Further, to relate findings to subject symptomatology expressed by bowel function scores and gastrointestinal transit time (GITT). SETTING: Aarhus University Hospital, Denmark. METHODS: Colorectal contents were marked by oral intake of (111)In-coated resin pellets. Movement of stools at defecation was assessed by comparing scintigrams performed before and just after defecation. Results from 15 subjects with SCI (14 males, median age=47 years (range: 22-74 years), SCI level: C5-Th9) were compared with those from 16 healthy volunteers (12 males, median age=31 years (range: 24-42 years)). Bowel symptoms were described from standard symptom scores, and GITT was assessed by radiopaque markers. RESULTS: Median emptying at defecation was 31% of the rectosigmoid (range: 0% to complete emptying of the rectosigmoid and 49% of the descending colon) in subjects with SCI and 89% of the rectosigmoid (range: 53% to complete emptying of the rectosigmoid and the descending colon, and 3% of the transverse colon) in the control group (P<0.01). Colorectal emptying at defecation was associated with the St Mark's fecal incontinence score (P=0.02) but not with the Cleveland constipation score (P=0.17), the neurogenic bowel dysfunction score (P=0.12) or GITT (P=0.99). CONCLUSION: Supraconal SCI results in significantly reduced emptying of stools at defecation. This is independent of changes in GITT.

Tuning the continuum ground state energy of NO2- 2 by water molecules.

Electron scattering on NO-2, NO-2 x (H2O), and NO-2 x (H2O)(2) was performed in two storage rings. We confirm the presence of earlier reported NO2-2 dianion resonances and show that they remain when water is attached. Importantly, hydration tunes the energy: each water molecule lowers the ground state energy by 0.8 +/- 0.3 eV relative to the monoanion. NO2-2 is observed to decay by two-electron emission, possibly in combination with fragmentation. NO(2-)2 x (H2O) mainly decays into NO-2 + H2O + e(-).

Electron scattering on OH-(H2O)n clusters (n = 0-4).

The cross sections for electron scattering on OH-(H2O)n for n = 0-4 were measured from threshold to approximately 50 eV. All detachment cross sections were found to follow the classical prediction given earlier [Phys. Rev. Lett. 74, 892 (1995)] with a threshold energy for electron-impact detachment that increased upon sequential hydration, yielding values in the range from 4.5 eV +/- 0.2 eV for OH- to 12.10 eV +/- 0.5 eV for OH-(H2O)4. For n > or = 1, we found that approximately 80% of the total reaction events lead to electron detachment plus total dissociation of the clusters into the constituent molecules of OH and H2O. Finally, we observed resonances in the cross sections for OH-(H2O)3 and for OH-(H2O)4. The resonances were located at approximately 15 eV and were ascribed to the formation of dianions in excited states.

Electron scattering on centrosymmetric molecular dianions Pt(CN)4(2-) and Pt(CN)6(2-).

Electron scattering on stored Pt(CN)2-4 and Pt(CN)2-6 centrosymmetric molecular dianions has been performed at the electrostatic storage ring ELISA. The thresholds for production of neutral particles by electron bombardment were found to be 17.2 and 18.7 eV, respectively. The relatively high thresholds reflect the strong Coulomb repulsion in the incoming channel as well as a high energetic stability of the target electrons. A trianion resonance was identified with a positive energy of 17.0 eV for the Pt(CN)2-4 square-planar complex, while three trianion resonances were identified for the Pt(CN)2-6 octahedral complex with positive energies of 15.3, 18.1, and 20.1 eV.